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Michael S. Ferrara and William E. Buckley

The Athletes With Disabilities Injury Registry (ADIR) was designed to collect and analyze injury data from 1990 to 1992. Three hundred nineteen athletes from different disability organizations participated, and 128 reportable injuries were recorded. The injury rate during the study period was 9.45/1,000 athlete-exposures. Overall, 52% of the reported injuries were minor (0–7 days missed), 29% were moderate (8–21 days missed), and 19% were major (22 or more days missed). The shoulder and forearm/wrist accounted for the most days lost, followed by the hand/fingers and the upper arm/elbow. Musculoskeletal injuries accounted for 81 % of the reported injuries, and illness or disability-related problems accounted for 19%. Fifteen percent of the moderate and major injuries were not medically evaluated. This raises questions about access to medical care and the appropriate recognition of an injury. Injury prevention programs should focus on reducing the number of major injuries and educating athletes and coaches about appropriate medical referrals.

Thomas M. Newman, Giampietro L. Vairo and William E. Buckley

Ankle sprains represent a common musculoskeletal injury that clinicians are tasked with preventing and treating. Because of the prevalence of this injury, ankle braces have been designed to prophylactically protect the joint and reduce the incidence of repetitive sprains. Although an abundance of literature exists focusing on the efficacy of braces in preventing ankle sprains in young, healthy, and physically active populations, there is a scarcity of evidence specific to the impact of these apparatuses on functional performance; therefore, the purpose of this critically appraised topic (CAT) is to investigate the effects of ankle braces on functional performance measures in such individuals. The outcomes of this CAT will assist sport rehabilitation specialists with informed clinical decision making in managing young, healthy, and physically active populations using ankle braces. Do ankle braces hinder functional performance measures when compared with an unbraced condition in a young, healthy, and physically active population? A minimum of level II evidence research studies were surveyed for this CAT. For this CAT, 1 randomized controlled trial and 3 prospective cohort studies were selected. One study found a statistically significant main effect of increased agility run times while participants wore ankle braces. Another study demonstrated a statistically significant decrease in vertical jump height and ankle range of motion while wearing braces. No other statistically significant findings were reported among studies comparing unbraced with braced conditions. Current data indicate that young, healthy, and physically active individuals may experience varied performance effects when executing specific functional performance tasks while wearing ankle braces. In general, bracing does not appear to significantly impair performance on most functional tasks; however, decrements were noted to increases in agility run time and decreases in vertical jump height. Subsequent analysis indicated that a brace may result in decreased ankle plantarflexion, dorsiflexion, eversion, and inversion range of motion, which may underpin noted performance deficits.

A variety of assessment devices have been developed for scientific investigation on human movement that can also be used to assess the progress of a rehabilitation program. The present investigation was undertaken to show how this technology can be combined with the most aggressive type of medical intervention and rehabilitation. Advanced technology was used to assess the physical rehabilitation parameters of active range of motion (AROM) and sport-specific functional progression for an Olympic-caliber diver who had bilateral wrist problems. AROM was measured for both wrists using a Flock of Birds motion-tracking device, and functional progression was assessed with an Advanced Mechanical Technology Inc. force platform for measuring the center of pressure (CP) area. The results of the treatment were clinically favorable, with an increase in AROM and a decrease in the CP area for functional motor control. The technology provided useful information about the progress of a rehabilitation program.

Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 ± 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.

Context: The Dynamic Leap Balance Test (DLBT) is a new dynamic balance task that requires serial changes in base of support with alternating limb support and recovery of dynamic stability, as compared with the Y modification of the Star Excursion Balance Test (Y-SEBT), which assesses dynamic stability over an unchanging base of support. Objectives: To assess the dynamic balance performance in 2 different types of dynamic balance tasks, the DLBT and the SEBT, in subjects with unilateral chronic ankle instability (CAI) when compared with matched controls. The authors hypothesized that the DLBT score would significantly differ between the CAI involved and uninvolved limbs (contralateral and healthy matched) and demonstrate a modest (r = .50) association with the SEBT scores. Design: Case-control. Setting: Controlled laboratory. Participants: A total of 36 physically active adults, 18 with history of unilateral CAI and 18 without history of ankle injury, were enrolled in the study. CAI subjects were identified using the Identification of Functional Ankle Instability questionnaire. Interventions: The DLBT and the SEBT were performed in a randomized order on a randomly selected limb in CAI and healthy subjects. Main Outcome Measures: Time taken to complete the DLBT and the reach distances performed on the SEBT were compared between the CAI and the healthy subjects. Results: There were no statistically significant differences (P < .05) in SEBT reach distances between groups. The DLBT time was greater (P < .01) for unstable ankles compared with the stable ankle. The authors found no correlation (P > .05) between DLBT time and any of the SEBT reach distances suggesting that the DLBT provides unique information in the assessment of patients with CAI. Conclusion: The DLBT challenges the ability to maintain postural control in CAI subjects differently than the SEBT. There is a need of more dynamic balance assessment tools that are functional and clinically relevant.